B0534 - Routine Liver Frailty Index Assessment as a Part of Pre-Liver Transplant Evaluation: Feasibility and Outcomes

Edgewood Warner II, MD, MPH¹, Ambika Chawla, ², Lauren Kim, ², Jane Preston, ², Anna Karen Chayaban, ², Marian Glick-Bauer, ², Farhana Ahmed, ², Rufino Singson, ², John Schachner, ², Nicholas Longobardi, ², Ronald Combs, ², Salima Makhani, MD², Sanjaya Satapathy, MD^2
1Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY; ²Northwell North Shore and Long Island Jewish, Manhasset, NY

Introduction: Frailty is a well-established risk factor for poor patient outcomes in patients with cirrhosis awaiting liver transplantation (LT). We assessed feasibility of routine use of Liver Frailty Index for pre-transplant evaluation.

Methods: Starting in June 2021, Northwell Health staff piloted routine use of LFI assessment as a part of the liver transplant evaluation of cirrhotic patients of different etiologies. Trained dieticians implemented the initial LFI assessment (which consisted of 3 rounds of handgrip strength, time to perform 5 chair stands, and time holding a side, semi-tandem and tandem balance positions) on 91 patients, including 58 from the outpatient setting and 33 from the inpatient setting.

Results: The predominant etiology of cirrhosis was alcohol-related, inpatient, 63.64% and outpatient, 34.48%, followed by non-alcoholic steatohepatitis. Patients evaluated for LFI in the inpatient setting were much sicker with higher MELD Na score (26.45±6.31 vs 15.97±6.73), had significantly higher prevalence of ascites (90.91% vs 51.72%), and more likely to be frail (5.38±1.13 vs 4.21±0.66, p =< 0.0001). The prevalence of Frail, Pre-frail, and robust group as assessed by LFI was 72.73%, 24.24% and 3.03% in the inpatient group as compared to 29.31%, 68.97%, and 1.72% in the outpatient group. The median hospital stay in the groups were 18.5, 6, 6 days in the Frail, pre-frail, and the robust groups.

Discussion: In this pilot program we have demonstrated that routine use of LFI for pretransplant evaluation is feasible. Frailty was present in 2/3rd of the hospitalized patients being evaluated for Liver Transplantation.



Disclosures:


Edgewood Warner II, MD, MPH¹, Ambika Chawla, ², Lauren Kim, ², Jane Preston, ², Anna Karen Chayaban, ², Marian Glick-Bauer, ², Farhana Ahmed, ², Rufino Singson, ², John Schachner, ², Nicholas Longobardi, ², Ronald Combs, ², Salima Makhani, MD², Sanjaya Satapathy, MD². B0534 - Routine Liver Frailty Index Assessment as a Part of Pre-Liver Transplant Evaluation: Feasibility and Outcomes, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.